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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Relationship between liver function tests & cardiovascular risk factors in stage 3-5 pre-dialysis chronic kidney
Tamer Selen1, Hadim Akoglu2, Kemal Agbaht3
1Department of Nephrology, Health Sciences University Ankara Dışkapı Yıldırım Beyazıt Education & Research Hospital, Ankara, Turkey.
Insights
Liver function tests (LFTs) correlate with cardiovascular risk factors in chronic kidney disease (CKD) patients, but this relationship is primarily influenced by impaired glomerular filtration rate (GFR).
Area of Science:
- Nephrology
- Cardiology
- Clinical Biochemistry
Background:
- Cardiovascular disease (CVD) is the leading cause of mortality in chronic kidney disease (CKD) patients.
- Liver function tests (LFTs) are being investigated as potential markers for CVD risk.
Purpose of the Study:
- To evaluate the relationship between LFTs and biochemical cardiovascular risk factors (CRFs) in pre-dialysis CKD patients.
Main Methods:
- Retrospective analysis of 246 stage 3-5 pre-dialysis CKD patients.
- Recorded demographics, LFTs (ALT, AST, GGT), and biochemical CRFs.
- Calculated glomerular filtration rate (GFR) using CKD-EPI equation.
Main Results:
- LFTs showed various correlations with CRFs and GFR.
- In diabetic patients, specific correlations between LFTs, GFR, and CRFs were observed.
- Partial correlation analysis indicated no direct link between LFTs and CRFs when GFR was controlled.
Conclusions:
- The observed relationships between LFTs and biochemical CRFs in CKD patients appear to be mediated by impaired GFR.
- LFTs may not be independent predictors of CRFs in this population.
Background & Objectives:
Cardiovascular disease (CVD) remains the leading cause of mortality among patients with chronic kidney disease (CKD). Liver function tests (LFTs) have emerged as markers of CVD risk in some population-based studies. Hence, in the present study the relation between LFTs and biochemical cardiovascular risk factors (CRFs) were evaluated in CKD patients.
Methods:
A total of 246 patients with stage 3-5 pre-dialysis CKD were enrolled. Demographics, LFTs [alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT)] and biochemical CRFs were recorded retrospectively. Glomerular filtration rate (GFR) was calculated using CKD-EPI equation.
Results:
ALT was positively correlated with GFR, albumin, triglyceride and 25-hydroxyvitamin D and negatively correlated with CRP and intact parathyroid hormone (iPTH); AST was positively correlated with GFR, albumin, high-density lipoprotein cholesterol (HDL-C) and 25-hydroxyvitamin D and negatively correlated with CRP and iPTH; GGT was positively correlated with GFR, CRP and triglyceride and negatively correlated with HDL-C. In diabetic patients, ALT correlated positively with GFR; AST correlated positively with GFR and HDL-C, but correlated negatively with iPTH. In the correlation analysis between GFR and CRF, GFR was positively correlated with albumin, triglyceride and 25-hydroxyvitamin D and negatively correlated with CRP, iPTH and albuminuria in both total study population and diabetic group. A partial correlation analysis revealed no correlation between LFTs and CRFs after being controlled for GFR.
Interpretation & Conclusions:
The results of the present study suggest that the relationship between LFTs and biochemical CRFs seems to be a function of impaired GFR.
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